Addiction Medicine Fellowship Program

The two-year Addiction Medicine Fellowship Program at Yale School of Medicine offers robust clinical and research training in Addiction Medicine. This novel program builds on Yale’s preeminence in the fields of Substance Abuse, Clinical Research and Medical Education and its international reputation for expanding addiction treatment into general medical settings (e.g. primary care, HIV care, emergency department). Working in close collaboration with our well-established Addiction Psychiatry training program and the Yale Division of Addictions, Addiction Medicine fellows, all of whom will have completed residency training, will

have the opportunity to rotate at several Yale-affiliated training sites as well as a number of community addiction treatment facilities;

take part in a robust Addiction Medicine didactic curriculum focusing on the bio-psycho-social treatment of patients with addiction; and

work with faculty from both the School of Medicine and the School of Public Health who are internationally recognized for epidemiologic and clinical trial research focusing on substance use and related medical (e.g. HIV, Hepatitis C, pain) and psychiatric co-morbidities

First Year

First-year fellows will obtain clinical training in Addiction Medicine through a variety of inpatient and outpatient training experiences. Training sites include Yale-New Haven Hospital and its affiliated outpatient clinics; The APT Foundation, a multi-specialty addiction treatment facility; and the South Central Rehabilitation Center. Additionally, fellows will have the opportunity to gain added training in the complex relationship between addiction and chronic pain. Opportunities to engage in clinical research or medical education projects will begin in the first year.

Second Year

The second year of the program will consist of a year-long practicum. The practicum component will consist of a Research Track or an Education Track, designed to train fellows for careers as clinician-investigators and clinician-educators, respectively. Both tracks share a common curriculum with a research component and a non-research component. The practicum will be tailored to the individual interest of the fellow and mentorship opportunities will be established.

Program Details

Mission

The mission of the Yale University Addiction Medicine Fellowship Program is to graduate trainees who will go on to become leaders in the field of Addiction Medicine. This will be accomplished by providing robust training in

the effective clinical care of patients with addictive disorders and their associated co-morbidities,

the conduct of clinical research in the field of addiction medicine, and

development of effective leadership, teaching and administrative skills applicable to the field of addiction medicine.

Didactics

Held in conjunction with didactics offered through the Addiction Psychiatry Fellowship Program

Required Rotations

Inpatient

Inpatient detoxification service - Fellows will complete new patient assessments and intakes, admit patients to the acute detoxifications facility and initiate the appropriate protocol, work with nursing staff on patient management, follow patients during their acute inpatient stay and assist in coordination of ongoing outpatient management.

Addiction Medicine Inpatient Consults - Fellows will assist faculty and housestaff rotating on the inpatient medicine service with patients admitted with addiction diagnoses. Fellows will serve a consultative and teaching role with regard to these patients and will assist in discharge planning for these patients.

Outpatient

APT Foundation Central Medical Unit or South Central Rehabilitation Center (SCRC) outpatient clinic - Longitudinal outpatient experience where fellows will primarily assess and manage patients with substance use disorders as well as their associated co-morbidities. Experiences will include admission evaluations and ongoing management for patients entering opioid agonist and antagonist maintenance (methadone, buprenorphine, naltrexone) and additional experiences tailored to the fellow’s clinical background and interests.

APT Foundation Access Center - Fellows will take part in new patient assessments, run treatment groups through the Intensive Outpatient Program, and act as the “doctor of the day” providing clinical leadership to the clinical staff at the Access Center and the Methadone Programs.

Addiction Medicine Chronic Disease Management Clinic - fellows will provide a consultative addiction medicine service to patients receiving care at the Adult Primary Care Center, the main primary care clinic serving over 5000 families in the greater New Haven area. In addition to new patient consultation, fellows will act as a liaison between the inpatient General Internal Medicine service and the outpatient clinic for those patients admitted with addiction diagnoses to Yale-New Haven St. Raphael Campus Hospital. Examples include initiating opioid pharmacotherapy for patients presenting with manifestations of opioid use disorder, providing alcohol pharmacotherapy for those patients admitted with alcohol use disorder and providing ongoing care, coordinating referrals from inpatient services to outpatient addiction treatment facilities, and providing consultative guidance.

Teaching Opportunities

Fellows will have several opportunities to participate in teaching initiatives including the Screening, Brief Intervention, and Referral to Treatment (SBIRT) teaching initiative at Yale University, the Alcohol Case Conference Series, Yale Affiliated Hospitals Teaching Program, teaching through the Addiction Medicine, Chronic Pain and Criminal Justice Elective offered to Yale Internal Medicine Housestaff, and the Yale Inpatient Smoking Cessation program training.

Scholarship

Scholarly activities are encouraged throughout the fellowship but are the focus of the second year of the fellowship. The second year of the program will consist of a year-long practicum. The practicum component will consist of a Research Track or an Education Track, designed to train addiction physicians for careers as clinician-investigators and clinician-educators, respectively. Both tracks share a common curriculum with a research component and a non-research component. The practicum will be tailored to the individual interest of the fellow and mentorship opportunities will be established. Training in clinical epidemiology and health services research is available for qualified applicants through the Yale Investigative Medicine Program and the Robert Wood Johnson Clinical Scholars Program. Training in medical education will be provided in conjunction with the Yale School of Medicine Teaching and Learning Center.

Electives

Yale New Haven Hospital Psychiatric Service – Fellows will work the inpatient psychiatry liaison consult service at Yale New Haven Hospital when consults come in regarding Addiction Medicine.

Intensive outpatient program – Fellows will work with patients who are newly entering treatment and receiving a minimum of 9 hours of treatment (group and individual counseling, psychiatric care) services per week.

Residential Services Division APT Foundation- Fellows will work with APT Foundation staff at this intensive residential addiction services program for adults with primary problems related to substance abuse or dependence.

Accreditation

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